Canterbury DHB

Context

Anti-Phospholipid Syndrome (APS)

Antibodies with specificity for phospholipids are associated with a predisposition to thrombosis in particular patient populations. To detect antiphospholipid antibodies, two assay techniques are required.

Anticardiolipin antibodies (ACA) are detected by an ELISA method using cardiolipin and the essential cofactor, beta-2 glycoprotein. However, coagulation studies using thromboplastin (SCT or DRVVT) are used to detect lupus anti-coagulant (LAC). It is important to recognise that prolongation of coagulation times are not always due to antiphospholipid antibodies. Anticardiolipin antibodies and the antibodies causing the lupus anticoagulant are different antiphospholipid antibodies that may or may not both be present in the same patient.

While the association of antiphospholipid antibodies and thrombosis is strong, particularly in patients suffering from systemic lupus erythematosis, the predictive value of these antibodies is less well defined. There is general consensus that individuals with a history of recurrent thrombosis or foetal loss who are antibody positive are at great risk of a further thrombotic event. They should be considered (as should cancer) as a cause of recurrent thrombosis despite standard dose warfarin.

The predictive value of antiphospholipid antibodies with respect to thrombosis in otherwise healthy individuals is more difficult to define. The guidelines presented here are an attempt to develop a consensus document after consideration of available data.

In This Section

Cardinal Features

Treatment Recommendations

Cardinal Features

Clinical features include:

Laboratory criteria:

Other features may be:

Note: Antiphospholipid antibodies may be associated with infections such as HIV, syphilis, malaria, and lymphomas and the use of phenothiazines, procainamide, phenytoin, quinidine and hydralazine.

About this Canterbury DHB document (5203):

Document Owner:

Mark Smith (see Who's Who)

Issue Date:

August 2016

Next Review:

August 2018

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5203